NPI | 1679194732 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NM 61550) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL aprn11008367) |
Enumeration Date | 2020-04-29 |
Last Update Date | 2023-11-13 |