NPI | 1073882510 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11016580) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 21744) |
363LF0000X Nurse Practitioner, Family (Licence: CO APN.0990332-NP) | |
Enumeration Date | 2011-12-28 |
Last Update Date | 2022-05-13 |