NPI | 1124704564 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11027108) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11027108) |
Enumeration Date | 2023-06-22 |
Last Update Date | 2024-04-19 |