NPI | 1912670373 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 24787) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC F11200792) |
Enumeration Date | 2021-07-30 |
Last Update Date | 2022-05-09 |