NPI | 1013594548 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11033915) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9438955) |
Enumeration Date | 2021-03-29 |
Last Update Date | 2024-08-26 |