NPI | 1124305040 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD R204907) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL ARNP9235489) |
Enumeration Date | 2011-11-05 |
Last Update Date | 2023-06-14 |