NPI | 1154910503 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11010776) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 11010776) |
Enumeration Date | 2021-01-11 |
Last Update Date | 2021-08-07 |