NPI | 1588277289 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2020028493) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AR 212496) |
Enumeration Date | 2020-08-24 |
Last Update Date | 2024-10-23 |