NPI | 1568701100 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 261QU0200X Clinic/Center, Urgent Care (Licence: SC 18982) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 173940) |
Enumeration Date | 2013-02-01 |
Last Update Date | 2018-04-27 |