NPI | 1740806207 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: LA 213947) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: LA RN135669) |
Enumeration Date | 2020-06-22 |
Last Update Date | 2021-01-25 |