NPI | 1700289667 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AL 1-095604) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: AL 1-095604) |
363LF0000X Nurse Practitioner, Family (Licence: MS R898358) | |
Enumeration Date | 2014-10-06 |
Last Update Date | 2025-08-04 |