NPI | 1982192324 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11024813) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA SP018654) |
363LF0000X Nurse Practitioner, Family (Licence: KS 5379837) | |
Enumeration Date | 2018-05-01 |
Last Update Date | 2024-01-31 |