NPI | 1093205049 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11002153) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: SC 21726) |
363L00000X Nurse Practitioner (Licence: NC 5010768) | |
Enumeration Date | 2018-05-15 |
Last Update Date | 2024-06-25 |