NPI | 1649876749 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD F11200588) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MD R160571) |
Enumeration Date | 2020-12-05 |
Last Update Date | 2023-12-20 |