NPI | 1730682295 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WY 1791) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CO APN.0993301-NP) |
Enumeration Date | 2018-03-12 |
Last Update Date | 2021-02-08 |