NPI | 1295245108 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OR 201800261NP-PP) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ARNP9378600) |
Enumeration Date | 2017-10-05 |
Last Update Date | 2020-04-09 |