NPI | 1104332790 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL ARNP9303022) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN9303022) |
Enumeration Date | 2017-12-19 |
Last Update Date | 2022-07-21 |