NPI | 1578343448 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 27885) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 355408) |
Enumeration Date | 2023-09-29 |
Last Update Date | 2024-10-30 |