NPI | 1043882699 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MT NUR-APRN-LIC-176635) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: MT NUR-APRN-LIC-176635) |
Enumeration Date | 2021-07-13 |
Last Update Date | 2023-03-22 |