NPI | 1174178214 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL 11013074) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 309309) |
Enumeration Date | 2019-08-06 |
Last Update Date | 2025-09-22 |