NPI | 1710591029 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11009111) |
Additional Taxonomies | 163WM0102X Registered Nurse, Maternal Newborn (Licence: FL 9304791) |
Enumeration Date | 2020-09-03 |
Last Update Date | 2020-12-18 |