NPI | 1023036456 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11021590) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 126546) |
Enumeration Date | 2006-07-17 |
Last Update Date | 2023-12-20 |