NPI | 1598163750 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MT APRN100230) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH COA. 16855-NP) |
363LF0000X Nurse Practitioner, Family (Licence: MT NUR-RN-LIC-21384) | |
Enumeration Date | 2014-12-19 |
Last Update Date | 2023-09-13 |