NPI | 1225839715 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11038099) |
Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: FL 11038099) |
Enumeration Date | 2025-03-21 |
Last Update Date | 2025-09-24 |