NPI | 1215518345 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11012834) |
Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: FL 4104) |
163W00000X Registered Nurse (Licence: FL 9505715) | |
363L00000X Nurse Practitioner (Licence: FL 11012834) | |
Enumeration Date | 2021-04-20 |
Last Update Date | 2024-09-26 |