NPI | 1952958720 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 25342) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA SP020741) |
Enumeration Date | 2019-08-26 |
Last Update Date | 2022-03-11 |