NPI | 1265822191 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL APRN11019824) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11019824) |
363L00000X Nurse Practitioner (Licence: IA H122741) | |
Enumeration Date | 2015-01-30 |
Last Update Date | 2023-06-19 |