NPI | 1851743645 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11016572) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AR A004758) |
Enumeration Date | 2016-07-06 |
Last Update Date | 2021-12-15 |