NPI | 1508174236 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL ARNP9335882) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AL 1-087622) |
363LF0000X Nurse Practitioner, Family (Licence: AL 1-087622) | |
Enumeration Date | 2010-09-15 |
Last Update Date | 2022-07-21 |