NPI | 1124889076 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5019449) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 386388) |
Enumeration Date | 2024-01-18 |
Last Update Date | 2025-09-15 |