NPI | 1235780537 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN1104137) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL APRN11004137) |
Enumeration Date | 2019-09-27 |
Last Update Date | 2024-08-16 |