NPI | 1124536438 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11030403) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA SP018398) |
Enumeration Date | 2018-01-21 |
Last Update Date | 2025-05-28 |