NPI | 1639826852 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD AC004201) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MD AC004201) |
363LF0000X Nurse Practitioner, Family (Licence: VA 0024183900) | |
363LF0000X Nurse Practitioner, Family (Licence: AL AC004201) | |
Enumeration Date | 2022-03-08 |
Last Update Date | 2023-01-31 |