NPI | 1053601815 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN9286651) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 4011863) |
363LF0000X Nurse Practitioner, Family (Licence: FL ARNP9286651) | |
Enumeration Date | 2011-04-13 |
Last Update Date | 2024-02-16 |