NPI | 1609318351 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11026812) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AZ 230954) |
363LF0000X Nurse Practitioner, Family (Licence: AL 1-117903) | |
Enumeration Date | 2016-11-11 |
Last Update Date | 2023-09-25 |