NPI | 1548726631 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 9341062) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 9341062) |
Enumeration Date | 2019-02-14 |
Last Update Date | 2020-03-16 |