NPI | 1679891741 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11004539) |
Additional Taxonomies | 133N00000X Nutritionist (Licence: FL ND5713) |
Enumeration Date | 2010-05-13 |
Last Update Date | 2019-10-11 |