NPI | 1205380896 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11009745) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9439144) |
Enumeration Date | 2016-08-11 |
Last Update Date | 2022-11-15 |