NPI | 1265184642 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11016854) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 5021138) |
Enumeration Date | 2022-01-26 |
Last Update Date | 2025-01-07 |