NPI | 1063218519 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN11038284) |
Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine (Licence: FL 678488) |
Enumeration Date | 2025-02-24 |
Last Update Date | 2025-04-15 |