NPI | 1568071389 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11014662) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CT 9015) |
Enumeration Date | 2020-07-28 |
Last Update Date | 2023-05-01 |