NPI | 1912550476 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN1100285) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 11002850) |
Enumeration Date | 2019-07-23 |
Last Update Date | 2023-11-14 |