NPI | 1235764424 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IA A157309) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA A157309) |
Enumeration Date | 2020-03-08 |
Last Update Date | 2022-01-19 |