NPI | 1609414135 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11005305) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 11005305) |
Enumeration Date | 2019-12-16 |
Last Update Date | 2023-01-04 |