NPI | 1245717115 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024190662) |
Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: NY 343829) |
363LP2300X Nurse Practitioner, Primary Care (Licence: FL 9251690) | |
Enumeration Date | 2018-07-24 |
Last Update Date | 2025-07-08 |