NPI | 1750563169 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 71004935B) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 097054) |
Enumeration Date | 2007-11-28 |
Last Update Date | 2022-07-21 |