NPI | 1255078101 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11015784) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 95020850) |
207QA0505X Family Medicine, Adult Medicine (Licence: FL 11015784) | |
Enumeration Date | 2022-05-12 |
Last Update Date | 2024-02-27 |