NPI | 1366993164 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 6783) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CT 6783) |
363LP2300X Nurse Practitioner, Primary Care (Licence: CT 6783) | |
Enumeration Date | 2016-10-18 |
Last Update Date | 2022-09-09 |