NPI | 1801360920 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11001113) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 9361261) |
Enumeration Date | 2019-01-11 |
Last Update Date | 2023-10-05 |