NPI | 1003089129 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11020658) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 13341) |
Enumeration Date | 2008-04-09 |
Last Update Date | 2023-12-19 |