NPI | 1124526561 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN9364713) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL ARNP9364713) |
Enumeration Date | 2018-01-31 |
Last Update Date | 2022-04-18 |