NPI | 1629720602 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11017604) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL APRN11017604) |
363LF0000X Nurse Practitioner, Family (Licence: FL 11017604) | |
Enumeration Date | 2022-01-21 |
Last Update Date | 2024-10-28 |