NPI | 1679399612 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: CO F07241377) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OR 10044592) |
Enumeration Date | 2024-11-25 |
Last Update Date | 2025-09-15 |