NPI | 1093186587 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11027576) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024173006) |
Enumeration Date | 2015-10-09 |
Last Update Date | 2024-03-22 |