NPI | 1851012421 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11024103) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 1073616) |
Enumeration Date | 2022-09-12 |
Last Update Date | 2023-09-04 |