NPI | 1881158731 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11000656) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NV 821505) |
Enumeration Date | 2019-01-24 |
Last Update Date | 2021-05-25 |