NPI | 1417561309 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11007955) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL APRN11007955) |
Enumeration Date | 2020-09-08 |
Last Update Date | 2021-03-02 |