NPI | 1003109661 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN9128482) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL APRN218482) |
Enumeration Date | 2011-05-16 |
Last Update Date | 2023-05-17 |