NPI | 1215489752 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11004498) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 340284) |
Enumeration Date | 2016-11-01 |
Last Update Date | 2023-04-18 |