NPI | 1568355105 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: SC 30315) |
Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: SC 30315) |
Enumeration Date | 2025-06-02 |
Last Update Date | 2025-09-15 |