NPI | 1669035705 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 261QU0200X Clinic/Center, Urgent Care (Licence: FL APRN11001751) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL APRN11001751) |
363LF0000X Nurse Practitioner, Family (Licence: FL APRN11001751) | |
Enumeration Date | 2019-04-15 |
Last Update Date | 2024-11-05 |