NPI | 1932507720 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11012244) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209012045) |
Enumeration Date | 2014-12-11 |
Last Update Date | 2021-09-30 |