NPI | 1255825782 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN9381425) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9381425) |
363L00000X Nurse Practitioner (Licence: FL ARNP9381425) | |
Enumeration Date | 2018-06-18 |
Last Update Date | 2023-04-04 |