NPI | 1902364805 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN9364047) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA SP021450) |
Enumeration Date | 2019-03-10 |
Last Update Date | 2024-03-21 |