NPI | 1104996461 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL APRN2683952) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 2683952) |
Enumeration Date | 2006-11-08 |
Last Update Date | 2024-06-19 |