NPI | 1407403538 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN9394351) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ARNP9394351) |
Enumeration Date | 2019-08-22 |
Last Update Date | 2023-04-10 |