NPI | 1164082020 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11002282) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL APRN11002282) |
Enumeration Date | 2019-06-13 |
Last Update Date | 2024-07-11 |