NPI | 1407410970 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11002198) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL 11002198) |
Enumeration Date | 2019-04-30 |
Last Update Date | 2024-10-14 |