NPI | 1477067122 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 9171961) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL RN9171961) |
Enumeration Date | 2017-11-16 |
Last Update Date | 2022-12-19 |