NPI | 1891398012 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN11019538) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 346308) |
Enumeration Date | 2020-11-19 |
Last Update Date | 2025-01-09 |