NPI | 1295278521 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 9213987) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN9213987) |
Enumeration Date | 2016-11-17 |
Last Update Date | 2019-12-06 |