NPI | 1154956977 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11012865) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IN 28197550A) |
Enumeration Date | 2020-03-12 |
Last Update Date | 2024-02-21 |