NPI | 1003258096 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL APRN9267591) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: DE LG-0000694) |
363LF0000X Nurse Practitioner, Family (Licence: DE LG-0000694) | |
363LF0000X Nurse Practitioner, Family (Licence: FL ARNP9267591) | |
Enumeration Date | 2013-07-19 |
Last Update Date | 2020-04-29 |