NPI | 1912418658 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 9298531) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: WA AP61452031) |
Enumeration Date | 2017-10-20 |
Last Update Date | 2023-08-14 |