NPI | 1558020172 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD R188535) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MD Pending) |
Enumeration Date | 2021-12-10 |
Last Update Date | 2022-05-02 |