NPI | 1083176366 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL 11001052) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 11001052) |
363LP2300X Nurse Practitioner, Primary Care (Licence: FL 11001052) | |
Enumeration Date | 2019-04-04 |
Last Update Date | 2021-02-17 |