NPI | 1699124560 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL ARNP9370960) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VT 101.0136528PROV) |
Enumeration Date | 2016-06-10 |
Last Update Date | 2023-09-18 |