NPI | 1013529817 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11028387) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9432881) |
Enumeration Date | 2020-08-21 |
Last Update Date | 2023-09-05 |