NPI | 1871144600 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ 11003759) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11003759) |
363LF0000X Nurse Practitioner, Family (Licence: FL 11003759) | |
Enumeration Date | 2019-09-23 |
Last Update Date | 2025-03-20 |