NPI | 1972114981 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AR 212859) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IA A160260) |
Enumeration Date | 2020-08-13 |
Last Update Date | 2020-10-20 |