NPI | 1619536554 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11020928) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AL 1-148862) |
Enumeration Date | 2019-06-12 |
Last Update Date | 2022-07-26 |