NPI | 1114643277 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11022150) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 11022150) |
Enumeration Date | 2022-10-19 |
Last Update Date | 2023-02-28 |