NPI | 1588286140 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11007206) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL F05200357) |
Enumeration Date | 2020-05-17 |
Last Update Date | 2022-11-14 |