NPI | 1205493327 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11002297) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL 11002297) |
363L00000X Nurse Practitioner (Licence: FL APRN11002297) | |
Enumeration Date | 2019-05-23 |
Last Update Date | 2023-06-12 |