NPI | 1578887824 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 9418050) |
Additional Taxonomies | 225700000X Massage Therapist (Licence: FL MA 57132) |
Enumeration Date | 2010-03-16 |
Last Update Date | 2022-11-17 |