NPI | 1457892226 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11005670) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN260247) |
363LF0000X Nurse Practitioner, Family (Licence: NJ 26NJ00774600) | |
Enumeration Date | 2017-03-13 |
Last Update Date | 2021-12-04 |