NPI | 1932503919 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11012906) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3008982) |
Enumeration Date | 2014-10-20 |
Last Update Date | 2021-07-07 |