NPI | 1023649274 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11005926) |
Additional Taxonomies | 163WG0100X Registered Nurse, Gastroenterology (Licence: FL RN9479297) |
363LF0000X Nurse Practitioner, Family (Licence: FL 11005926) | |
Enumeration Date | 2020-01-27 |
Last Update Date | 2024-06-17 |