NPI | 1316508146 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11023481) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MS 855949) |
Enumeration Date | 2019-06-24 |
Last Update Date | 2025-05-13 |