NPI | 1104284454 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN9339856) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL 9339856) |
Enumeration Date | 2016-02-02 |
Last Update Date | 2024-04-01 |