NPI | 1609375088 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: LA 202766) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 1056739) |
Enumeration Date | 2018-02-12 |
Last Update Date | 2024-08-13 |