NPI | 1265086805 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11001828) |
Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: FL DH20090) |
Enumeration Date | 2019-07-31 |
Last Update Date | 2024-01-18 |