NPI | 1548850134 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ 261026) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA 95013446) |
Enumeration Date | 2021-01-19 |
Last Update Date | 2021-10-11 |