NPI | 1174298814 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11018438) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 348114) |
Enumeration Date | 2021-08-13 |
Last Update Date | 2022-04-19 |