NPI | 1114661857 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11019784) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3016956) |
363L00000X Nurse Practitioner (Licence: FL APRN11019784) | |
363LF0000X Nurse Practitioner, Family (Licence: KY 3016956) | |
Enumeration Date | 2022-04-27 |
Last Update Date | 2022-08-04 |