NPI | 1376285411 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11024024) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MD R199523) |
Enumeration Date | 2022-04-09 |
Last Update Date | 2023-07-07 |