NPI | 1578841169 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11006157) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-75450-012) |
363LF0000X Nurse Practitioner, Family (Licence: OK 109050) | |
Enumeration Date | 2011-07-29 |
Last Update Date | 2022-10-12 |