NPI | 1679950687 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN9279055) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL ARNP 9279055) |
Enumeration Date | 2015-04-28 |
Last Update Date | 2019-07-29 |