NPI | 1780045377 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024172495) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2325118) |
Enumeration Date | 2016-03-10 |
Last Update Date | 2024-10-07 |