NPI | 1104476423 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AL 1-145365) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024183267) |
363LF0000X Nurse Practitioner, Family (Licence: TX 1060455) | |
363LF0000X Nurse Practitioner, Family (Licence: GA GAA-NP000660) | |
363LF0000X Nurse Practitioner, Family (Licence: FL APRN11018700) | |
363LP2300X Nurse Practitioner, Primary Care (Licence: AL 1-145365) | |
Enumeration Date | 2019-09-18 |
Last Update Date | 2023-02-01 |