NPI | 1679094957 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AL 1-131072) |
Additional Taxonomies | 261Q00000X Clinic/Center |
Enumeration Date | 2017-06-27 |
Last Update Date | 2023-11-28 |