NPI | 1013425727 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN9319636) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL APRN9319636) |
207Q00000X Family Medicine (Licence: FL ARNP9319636) | |
Enumeration Date | 2018-01-16 |
Last Update Date | 2023-06-08 |