NPI | 1407518566 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 261QU0200X Clinic/Center, Urgent Care |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CO 0003332) |
Enumeration Date | 2021-10-06 |
Last Update Date | 2024-09-13 |