NPI | 1720753759 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5014897) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC STEP-EX3X8) |
Enumeration Date | 2021-08-11 |
Last Update Date | 2023-06-23 |