NPI | 1083227102 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL APRN11008057) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 11008057) |
Enumeration Date | 2020-08-28 |
Last Update Date | 2021-03-10 |