NPI | 1235741307 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11008068) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9406426) |
Enumeration Date | 2020-08-20 |
Last Update Date | 2023-09-29 |