NPI | 1366018111 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11013226) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: FL APRN11013226) |
Enumeration Date | 2021-06-02 |
Last Update Date | 2025-07-28 |