NPI | 1740742006 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WY 48988) |
Additional Taxonomies | 163WC1500X Registered Nurse, Community Health (Licence: WY 48988) |
Enumeration Date | 2019-04-04 |
Last Update Date | 2023-11-06 |