NPI | 1083088033 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11024243) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA RN175307) |
Enumeration Date | 2015-11-13 |
Last Update Date | 2024-02-19 |