NPI | 1487316030 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11015893) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL APRN11015893) |
Enumeration Date | 2021-10-12 |
Last Update Date | 2024-04-15 |