NPI | 1770952525 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN1108325) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2015032906) |
363LF0000X Nurse Practitioner, Family (Licence: KS 77943) | |
Enumeration Date | 2015-09-23 |
Last Update Date | 2021-12-07 |