NPI | 1689206856 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 28770) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 11005742) |
363LF0000X Nurse Practitioner, Family (Licence: FL 54942) | |
Enumeration Date | 2020-02-06 |
Last Update Date | 2024-09-19 |