NPI | 1588369003 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ 301422) |
Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: AZ 301422) |
Enumeration Date | 2023-04-03 |
Last Update Date | 2025-04-11 |