NPI | 1174080253 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11006070) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9372881) |
Enumeration Date | 2019-02-26 |
Last Update Date | 2024-11-19 |