NPI | 1700399060 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN9291781) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: GA RN190618) |
Enumeration Date | 2017-11-08 |
Last Update Date | 2020-01-22 |