NPI | 1548726136 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11001999) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AL 1-103793) |
Enumeration Date | 2019-02-19 |
Last Update Date | 2019-09-12 |