NPI | 1861063679 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 28268) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MD R214872) |
Enumeration Date | 2021-07-03 |
Last Update Date | 2024-01-14 |