NPI | 1760021539 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 8667) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CT 8667) |
Enumeration Date | 2019-12-27 |
Last Update Date | 2023-11-01 |