NPI | 1679253421 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11026348) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 11026348) |
Enumeration Date | 2023-07-18 |
Last Update Date | 2024-01-12 |