NPI | 1720754674 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: AL 1-155978) |
Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: AL 1-155978) |
Enumeration Date | 2021-08-20 |
Last Update Date | 2023-07-17 |