NPI | 1881260602 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: FL 11012657) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL APRN11012657) |
Enumeration Date | 2021-06-02 |
Last Update Date | 2025-07-14 |