NPI | 1902321151 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN9361744) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA SP018326) |
Enumeration Date | 2017-08-09 |
Last Update Date | 2022-07-21 |