NPI | 1710503602 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN11007430) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11007430) |
Enumeration Date | 2020-06-17 |
Last Update Date | 2023-03-22 |