NPI | 1073267803 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 8482086-4405) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: UT 8482086-4405) |
Enumeration Date | 2022-02-10 |
Last Update Date | 2022-02-10 |