NPI | 1922520154 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL 11008750) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209015316) |
Enumeration Date | 2017-07-10 |
Last Update Date | 2021-07-09 |