NPI | 1073023586 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11032409) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2017037187) |
Enumeration Date | 2017-10-10 |
Last Update Date | 2024-07-18 |