NPI | 1720690068 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11008642) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 11008642) |
Enumeration Date | 2020-08-18 |
Last Update Date | 2024-09-26 |