NPI | 1598417222 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 25861) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CT 12.010343) |
Enumeration Date | 2022-01-24 |
Last Update Date | 2022-06-14 |