NPI | 1629613328 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: AL 1-155257) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: AL 1-155257) |
Enumeration Date | 2019-11-17 |
Last Update Date | 2023-03-27 |