NPI | 1316417074 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN9328939) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: LA 220572) |
Enumeration Date | 2018-11-26 |
Last Update Date | 2021-07-14 |