NPI | 1609279314 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11011390) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IN 71005194A) |
Enumeration Date | 2014-10-08 |
Last Update Date | 2024-03-27 |