NPI | 1629612288 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS 906151) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: LA 232176) |
Enumeration Date | 2019-11-06 |
Last Update Date | 2024-01-31 |