NPI | 1558817684 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN9298919) |
Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: FL 9298919) |
Enumeration Date | 2016-08-29 |
Last Update Date | 2021-01-10 |