NPI | 1699004150 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN9343619) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MD R174023) |
Enumeration Date | 2009-12-12 |
Last Update Date | 2024-01-29 |