NPI | 1578116851 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11029828) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024177316) |
Enumeration Date | 2019-07-16 |
Last Update Date | 2023-12-18 |