NPI | 1508104563 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL ARNP9272783) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9272783) |
Enumeration Date | 2013-01-26 |
Last Update Date | 2022-03-10 |