NPI | 1003396714 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN9320665) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL ARNP9320665) |
Enumeration Date | 2018-08-21 |
Last Update Date | 2019-03-28 |