NPI | 1124548532 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN9185254) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL arnp9185254) |
Enumeration Date | 2017-06-27 |
Last Update Date | 2022-12-06 |