NPI | 1881213247 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN11037144) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: PR 000288-PA) |
Enumeration Date | 2020-04-15 |
Last Update Date | 2025-01-14 |