NPI | 1811385354 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL ARNP 9196062) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024172200) |
363LF0000X Nurse Practitioner, Family (Licence: NC 5007419) | |
Enumeration Date | 2015-01-07 |
Last Update Date | 2021-04-20 |