NPI | 1114688801 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD F12210722) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MD R177508) |
Enumeration Date | 2022-01-04 |
Last Update Date | 2022-01-14 |