NPI | 1740890367 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: LA 215697) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 1000926) |
Enumeration Date | 2020-08-07 |
Last Update Date | 2022-10-27 |