NPI | 1790213148 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN9250661) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL ARNP9250661) |
Enumeration Date | 2017-05-30 |
Last Update Date | 2025-09-08 |