NPI | 1497420129 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD F05210848) |
Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: MD R187414) |
Enumeration Date | 2021-08-13 |
Last Update Date | 2025-02-18 |