NPI | 1104300185 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN9184976) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 9184976) |
Enumeration Date | 2018-09-17 |
Last Update Date | 2024-08-08 |