NPI | 1548040207 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GU 100414) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11028422) |
Enumeration Date | 2023-10-02 |
Last Update Date | 2025-09-16 |