NPI | 1124772454 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11018117) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL 9406648) |
Enumeration Date | 2022-02-06 |
Last Update Date | 2022-07-12 |