NPI | 1215970645 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11017781) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA RN201459) |
Enumeration Date | 2006-06-14 |
Last Update Date | 2023-01-25 |