NPI | 1750055729 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024181599) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 29768) |
Enumeration Date | 2021-08-04 |
Last Update Date | 2025-10-16 |