NPI | 1750901328 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS 904927) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: MS 901117) |
Enumeration Date | 2020-04-23 |
Last Update Date | 2021-10-19 |