NPI | 1255976775 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11022464) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL APRN11022464) |
207R00000X Internal Medicine (Licence: FL 641062) | |
Enumeration Date | 2019-11-07 |
Last Update Date | 2024-04-04 |