NPI | 1821336694 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN9495682) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 569704) |
Enumeration Date | 2013-01-29 |
Last Update Date | 2020-04-03 |