NPI | 1487170502 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CO APN.0995607-NP) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: NM CNP-02757) |
Enumeration Date | 2017-08-21 |
Last Update Date | 2021-02-08 |