NPI | 1558712711 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2016022818) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2011003776) |
Enumeration Date | 2016-06-28 |
Last Update Date | 2023-11-02 |