NPI | 1275939589 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN9268512) |
Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: FL ARNP9268512) |
Enumeration Date | 2014-11-13 |
Last Update Date | 2021-08-19 |