NPI | 1265090179 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: LA 205889) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: LA 205889) |
Enumeration Date | 2019-06-05 |
Last Update Date | 2024-04-30 |