NPI | 1689157406 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024176482) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VA 0024176482) |
Enumeration Date | 2018-09-07 |
Last Update Date | 2021-06-28 |