NPI | 1205490059 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11030674) |
Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: FL 11030674) |
Enumeration Date | 2019-04-26 |
Last Update Date | 2025-02-04 |