NPI | 1255672796 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 9253468) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL ARNP 9253468) |
Enumeration Date | 2013-03-07 |
Last Update Date | 2017-11-22 |