NPI | 1659859437 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5015092) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NM 53406) |
363LF0000X Nurse Practitioner, Family (Licence: FL APRN11009436) | |
Enumeration Date | 2018-08-02 |
Last Update Date | 2021-09-22 |