NPI | 1205562246 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11019337) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 95021794) |
Enumeration Date | 2022-07-30 |
Last Update Date | 2024-12-01 |