NPI | 1285305649 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11028624) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 25427) |
Enumeration Date | 2021-09-24 |
Last Update Date | 2024-08-23 |