NPI | 1134220692 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: FL 9185928) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 9185928) |
Enumeration Date | 2006-09-26 |
Last Update Date | 2021-01-26 |