NPI | 1710433537 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11007993) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209014508) |
Enumeration Date | 2016-08-31 |
Last Update Date | 2023-06-21 |