NPI | 1528459583 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN9389542) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9389542) |
Enumeration Date | 2015-02-12 |
Last Update Date | 2024-05-07 |