NPI | 1043798176 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: FL APRN9400356) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL 9400356) |
Enumeration Date | 2018-07-31 |
Last Update Date | 2019-02-13 |