NPI | 1457909657 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN11003966) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL F07191474) |
Enumeration Date | 2019-08-30 |
Last Update Date | 2025-03-20 |