NPI | 1396466728 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11029783) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AZ 279165) |
Enumeration Date | 2022-09-05 |
Last Update Date | 2024-03-07 |