NPI | 1598361925 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL 11007665) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.026328) |
363L00000X Nurse Practitioner (Licence: CA 95014786) | |
Enumeration Date | 2020-12-10 |
Last Update Date | 2024-07-24 |