NPI | 1659625309 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5005881) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 193345) |
Enumeration Date | 2012-11-02 |
Last Update Date | 2023-01-10 |