NPI | 1861530297 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN9254482) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9254482) |
Enumeration Date | 2007-02-01 |
Last Update Date | 2023-11-15 |