NPI | 1609303411 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2009006067) |
Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
Enumeration Date | 2017-05-11 |
Last Update Date | 2025-03-27 |