NPI | 1609335744 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 22568) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 5011591) |
363LF0000X Nurse Practitioner, Family (Licence: FL APRN11037798) | |
Enumeration Date | 2019-03-18 |
Last Update Date | 2025-02-19 |