NPI | 1558807693 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 9177494) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024182958) |
Enumeration Date | 2017-01-12 |
Last Update Date | 2024-03-18 |