NPI | 1629811286 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11034204) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 11034204) |
363LF0000X Nurse Practitioner, Family (Licence: SC 29470) | |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2024-06-13 |
Last Update Date | 2025-07-02 |