NPI | 1104550425 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95025230) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX 1087438) |
363L00000X Nurse Practitioner (Licence: FL APRN11038996) | |
Enumeration Date | 2022-07-12 |
Last Update Date | 2025-09-19 |