NPI | 1568015873 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ 308088) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NM 56979) |
Enumeration Date | 2019-07-17 |
Last Update Date | 2024-07-18 |