NPI | 1831704089 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11021577) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA SP022357) |
Enumeration Date | 2020-09-14 |
Last Update Date | 2022-10-26 |