NPI | 1871193755 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11009936) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 350880) |
Enumeration Date | 2020-10-29 |
Last Update Date | 2024-01-03 |