NPI | 1255688875 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN9254332) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL ARNP9254332) |
Enumeration Date | 2012-08-14 |
Last Update Date | 2020-01-16 |