NPI | 1104390335 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ 247838) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN3129922) |
Enumeration Date | 2019-01-22 |
Last Update Date | 2023-06-23 |