NPI | 1376133397 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11033869) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9508781) |
Enumeration Date | 2021-01-23 |
Last Update Date | 2024-07-09 |