NPI | 1578884326 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN9419562) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA sp010756) |
363LF0000X Nurse Practitioner, Family (Licence: AZ AP3885) | |
Enumeration Date | 2010-06-16 |
Last Update Date | 2020-02-20 |