NPI | 1174124507 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 28225) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: TN 28225) |
Enumeration Date | 2020-11-03 |
Last Update Date | 2024-09-12 |