NPI | 1518510965 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11003375) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3013550) |
Enumeration Date | 2019-07-24 |
Last Update Date | 2024-11-25 |