NPI | 1528573573 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AL 1-129596) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: AL 1-129596) |
207Q00000X Family Medicine (Licence: FL APRN11014337) | |
Enumeration Date | 2017-12-12 |
Last Update Date | 2024-01-03 |