NPI | 1760080782 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11009654) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL APRN11009654) |
Enumeration Date | 2020-10-12 |
Last Update Date | 2023-03-29 |