NPI | 1811343791 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11025333) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CA 95003847) |
Enumeration Date | 2016-05-10 |
Last Update Date | 2023-05-26 |