NPI | 1780220418 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL 11004996) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 1070791) |
Enumeration Date | 2019-11-18 |
Last Update Date | 2024-02-11 |