NPI | 1639360589 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN9165755) |
Additional Taxonomies | 363LW0102X Nurse Practitioner, Women's Health (Licence: FL ARNP9165755) |
Enumeration Date | 2007-08-06 |
Last Update Date | 2019-11-01 |