NPI | 1285253757 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN11017408) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9487401) |
363LF0000X Nurse Practitioner, Family (Licence: FL APRN11017408) | |
Enumeration Date | 2020-04-14 |
Last Update Date | 2022-09-19 |