NPI | 1194330175 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL APRN11009158) |
Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL 11009158) |
Enumeration Date | 2020-09-15 |
Last Update Date | 2024-08-14 |