NPI | 1669237160 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 10042963) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: UT 6914624-4405) |
163W00000X Registered Nurse (Licence: UT 6914624-3102) | |
163W00000X Registered Nurse (Licence: OR 10042963) | |
Enumeration Date | 2024-02-14 |
Last Update Date | 2025-10-01 |