NPI | 1104233220 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN9250762) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL ARNP 9250762) |
Enumeration Date | 2014-07-21 |
Last Update Date | 2019-02-27 |