NPI | 1770568339 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN2048012) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL APRN2048012) |
Enumeration Date | 2005-12-07 |
Last Update Date | 2020-11-09 |