NPI | 1255707279 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN9473020) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5007845) |
Enumeration Date | 2015-08-13 |
Last Update Date | 2023-10-05 |