| NPI | 1780421875 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: AK 227348) |
| Enumeration Date | 2024-07-15 |
| Last Update Date | 2024-08-30 |