NPI | 1245536697 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN9422087) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MD R121608) |
Enumeration Date | 2011-02-02 |
Last Update Date | 2024-05-02 |