NPI | 1396125241 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11030082) |
Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: FL 11030082) |
Enumeration Date | 2015-06-05 |
Last Update Date | 2025-09-22 |