NPI | 1114642261 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11027324) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH 0032466) |
Enumeration Date | 2022-10-10 |
Last Update Date | 2023-07-11 |