NPI | 1679124259 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11003561) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CT 10979) |
Enumeration Date | 2019-09-24 |
Last Update Date | 2023-06-20 |