NPI | 1982115242 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11022774) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN219155) |
363LF0000X Nurse Practitioner, Family (Licence: NV 836051) | |
Enumeration Date | 2017-10-13 |
Last Update Date | 2023-06-30 |