NPI | 1780109710 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NV 822796) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AZ AP10491) |
Enumeration Date | 2017-08-10 |
Last Update Date | 2024-10-30 |