NPI | 1710540893 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11039191) |
Additional Taxonomies | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant |
Enumeration Date | 2019-04-15 |
Last Update Date | 2025-05-06 |