NPI | 1720566482 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN9328758) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AL 1-158696) |
Enumeration Date | 2018-08-03 |
Last Update Date | 2020-04-24 |