NPI | 1134582711 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: FL ARNP9407892) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL rn9407892) |
Enumeration Date | 2016-04-01 |
Last Update Date | 2021-12-07 |