NPI | 1174295000 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11020326) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5015318) |
Enumeration Date | 2021-09-29 |
Last Update Date | 2023-12-07 |