NPI | 1548649973 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CO 0992047) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: UT 14187449-4405) |
Enumeration Date | 2015-05-18 |
Last Update Date | 2025-04-17 |