NPI | 1780318048 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA SP030412) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CT 10712) |
Enumeration Date | 2022-07-13 |
Last Update Date | 2024-09-09 |