NPI | 1396318853 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11014209) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: FL 11014209) |
Enumeration Date | 2021-07-22 |
Last Update Date | 2023-10-13 |