NPI | 1134703853 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: FL APRN11012075) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL F03210316) |
Enumeration Date | 2021-05-09 |
Last Update Date | 2025-01-10 |