NPI | 1639780414 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NE 113265) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IA A160353) |
Enumeration Date | 2020-08-13 |
Last Update Date | 2024-09-25 |