NPI | 1922873009 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL F04210057) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY 354335) |
363LF0000X Nurse Practitioner, Family (Licence: GA GAA-NP001919) | |
Enumeration Date | 2023-11-20 |
Last Update Date | 2025-08-14 |