NPI | 1134847940 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11012498) |
Additional Taxonomies | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: FL APRN11012498) |
Enumeration Date | 2022-08-17 |
Last Update Date | 2022-10-25 |