NPI | 1114401379 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11027875) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH APRN.CNP.023542) |
363LF0000X Nurse Practitioner, Family (Licence: GA RN207049) | |
Enumeration Date | 2018-09-23 |
Last Update Date | 2025-02-04 |