NPI | 1902495674 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11011975) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AR 212755) |
Enumeration Date | 2021-01-15 |
Last Update Date | 2023-07-07 |