NPI | 1780074682 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL ARNP9348007) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 9348007) |
Enumeration Date | 2015-01-29 |
Last Update Date | 2019-01-09 |