NPI | 1073081345 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 9384378) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL APRN9384378) |
Enumeration Date | 2018-11-05 |
Last Update Date | 2022-10-27 |