NPI | 1710376447 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11009484) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 5007402) |
363LF0000X Nurse Practitioner, Family (Licence: MA RN276961) | |
Enumeration Date | 2015-01-19 |
Last Update Date | 2025-06-30 |