NPI | 1548056039 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD R250522) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: MD R250522) |
Enumeration Date | 2025-04-19 |
Last Update Date | 2025-08-17 |