NPI | 1275021206 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN9488041) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MD R226824) |
Enumeration Date | 2018-04-25 |
Last Update Date | 2019-10-08 |