NPI | 1912409053 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AL 1-136202) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11036461) |
Enumeration Date | 2018-03-05 |
Last Update Date | 2025-01-21 |