NPI | 1205498078 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL 11003194) |
Additional Taxonomies | 163WM0705X Registered Nurse, Medical-Surgical (Licence: FL RN9390112) |
Enumeration Date | 2019-07-02 |
Last Update Date | 2020-01-28 |