NPI | 1487149316 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11003822) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 1136066) |
363LF0000X Nurse Practitioner, Family (Licence: NY F343100-1) | |
Enumeration Date | 2018-06-23 |
Last Update Date | 2024-02-23 |