NPI | 1487118964 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11022878) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MS 903160) |
Enumeration Date | 2019-01-29 |
Last Update Date | 2023-09-19 |