NPI | 1629435037 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL ARNP9309196) |
Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care (Licence: FL 9309196) |
Enumeration Date | 2016-01-15 |
Last Update Date | 2021-03-24 |