NPI | 1942885553 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024188881) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AZ 254782) |
Enumeration Date | 2021-03-15 |
Last Update Date | 2024-05-21 |