NPI | 1952870628 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11017974) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AZ 219330) |
Enumeration Date | 2018-11-24 |
Last Update Date | 2022-05-02 |