NPI | 1710435987 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 26323) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 341073) |
Enumeration Date | 2016-09-16 |
Last Update Date | 2020-05-18 |