NPI | 1558781534 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11005573) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA NP: RN171898) |
Enumeration Date | 2014-04-17 |
Last Update Date | 2025-06-03 |