NPI | 1952008633 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: TN 33356) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AL 3-001422) |
Enumeration Date | 2023-02-13 |
Last Update Date | 2023-11-03 |