NPI | 1023581436 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11000831) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CT 11417) |
Enumeration Date | 2019-01-08 |
Last Update Date | 2023-06-14 |