NPI | 1174095616 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11000524) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9354996) |
Enumeration Date | 2018-12-21 |
Last Update Date | 2024-02-22 |