NPI | 1639700503 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN11016034) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 23574) |
Enumeration Date | 2020-01-30 |
Last Update Date | 2023-09-21 |