NPI | 1861058406 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11002410) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 11002410) |
Enumeration Date | 2019-05-18 |
Last Update Date | 2021-01-14 |