NPI | 1164140281 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: ID 70287) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA 644524) |
363L00000X Nurse Practitioner (Licence: CA 95015168) | |
363L00000X Nurse Practitioner (Licence: ID 70287) | |
Enumeration Date | 2022-08-15 |
Last Update Date | 2024-05-30 |