NPI | 1326766197 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11021567) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9394475) |
363LF0000X Nurse Practitioner, Family (Licence: FL F08220664) | |
Enumeration Date | 2022-08-18 |
Last Update Date | 2025-02-06 |