NPI | 1003457623 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11004214) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL APRN11004214) |
Enumeration Date | 2019-10-04 |
Last Update Date | 2024-03-21 |