NPI | 1972116309 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11023500) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 346528) |
Enumeration Date | 2020-08-25 |
Last Update Date | 2024-09-17 |