NPI | 1811514722 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11007696) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AL 1-097016) |
363LP0200X Nurse Practitioner, Pediatrics (Licence: FL 11007696) | |
Enumeration Date | 2020-06-26 |
Last Update Date | 2025-08-03 |