NPI | 1104424035 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11009403) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL APRN11009403) |
Enumeration Date | 2020-10-13 |
Last Update Date | 2024-10-04 |