NPI | 1205138948 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11003353) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: ID NP-1026A) |
Enumeration Date | 2010-12-01 |
Last Update Date | 2021-04-21 |