NPI | 1790660348 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11041367) |
Additional Taxonomies | 207Y00000X Otolaryngology (Licence: FL APRN11041367) |
Enumeration Date | 2025-08-11 |
Last Update Date | 2025-10-01 |