NPI | 1992115042 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11003684) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MD R147717) |
Enumeration Date | 2014-04-29 |
Last Update Date | 2024-02-24 |