NPI | 1518678671 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11023364) |
Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: FL 11023364) |
363LP2300X Nurse Practitioner, Primary Care (Licence: FL APRN11023364) | |
Enumeration Date | 2022-12-09 |
Last Update Date | 2024-10-29 |