NPI | 1629471602 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN11033598) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3008916) |
Enumeration Date | 2014-10-03 |
Last Update Date | 2024-10-16 |