NPI | 1932739620 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2020002135) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 2020002135) |
Enumeration Date | 2020-01-22 |
Last Update Date | 2023-11-21 |