NPI | 1538754189 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5017499) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA SP023630) |
Enumeration Date | 2021-03-05 |
Last Update Date | 2024-02-09 |