NPI | 1790057727 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL APRN11025955) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: PA SP011616) |
363LF0000X Nurse Practitioner, Family (Licence: NJ 26NJ00356600) | |
Enumeration Date | 2012-02-07 |
Last Update Date | 2025-02-21 |