NPI | 1740686195 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: FL 9396065) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL ARNP9396065) |
Enumeration Date | 2014-11-12 |
Last Update Date | 2021-03-11 |