NPI | 1275144362 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN11006630) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 11006630) |
363LF0000X Nurse Practitioner, Family (Licence: FL APRN11006630) | |
Enumeration Date | 2020-08-12 |
Last Update Date | 2021-05-26 |