NPI | 1639736770 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2022012950) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 95010622) |
Enumeration Date | 2019-05-23 |
Last Update Date | 2024-09-17 |