NPI | 1366097685 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL APRN11002438) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 11002438) |
Enumeration Date | 2019-08-04 |
Last Update Date | 2023-06-15 |