NPI | 1629558572 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD R147715) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: MD R147715) |
Enumeration Date | 2018-08-20 |
Last Update Date | 2021-07-26 |