NPI | 1649780990 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: FL 9220819) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 9220819) |
Enumeration Date | 2017-10-01 |
Last Update Date | 2021-07-19 |