NPI | 1649777848 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2018012287) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2018012287) |
Enumeration Date | 2018-04-12 |
Last Update Date | 2024-04-23 |