NPI | 1710194311 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 2811112) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN2811112) |
Enumeration Date | 2007-05-16 |
Last Update Date | 2020-09-13 |