NPI | 1992179741 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ 316678) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 5376881072) |
Enumeration Date | 2015-11-17 |
Last Update Date | 2025-01-27 |