NPI | 1407936164 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN9354066) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NJ 26NJ00086100) |
363LF0000X Nurse Practitioner, Family (Licence: TN 15345) | |
Enumeration Date | 2006-10-17 |
Last Update Date | 2020-08-19 |