NPI | 1285060079 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11012639) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9560905) |
Enumeration Date | 2013-09-24 |
Last Update Date | 2021-06-03 |