NPI | 1023414083 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 125079384) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 01095560A) |
363L00000X Nurse Practitioner (Licence: FL ARNP9250915) | |
390200000X Student in an Organized Health Care Education/Training Program (Licence: IL 125.079384) | |
Enumeration Date | 2014-11-18 |
Last Update Date | 2025-06-16 |