NPI | 1669193397 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11017228) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 11017228) |
Enumeration Date | 2022-09-12 |
Last Update Date | 2025-01-10 |