NPI | 1316573173 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11007178) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 1081153) |
Enumeration Date | 2020-03-12 |
Last Update Date | 2024-01-16 |