NPI | 1003695727 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD F09230709) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX 1140075) |
Enumeration Date | 2023-09-22 |
Last Update Date | 2025-04-06 |