NPI | 1588260301 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11014925) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL NP9330201) |
Enumeration Date | 2020-12-07 |
Last Update Date | 2023-01-30 |