NPI | 1003221672 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: FL APRN11024536) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL ARNP9279940) |
363LF0000X Nurse Practitioner, Family (Licence: CT 5759) | |
Enumeration Date | 2014-06-23 |
Last Update Date | 2025-02-25 |