NPI | 1609661685 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11035232) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9446018) |
Enumeration Date | 2025-04-10 |
Last Update Date | 2025-09-04 |