NPI | 1255927471 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11026645) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9507395) |
Enumeration Date | 2020-12-13 |
Last Update Date | 2024-12-08 |