NPI | 1558040675 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 7870638-4405) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: UT 7870638-3102) |
Enumeration Date | 2023-07-17 |
Last Update Date | 2024-05-07 |