NPI | 1669996062 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: VA 0024175178) |
Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine (Licence: VA 0024175178) |
363LP2300X Nurse Practitioner, Primary Care (Licence: VA 0024175178) | |
Enumeration Date | 2017-07-28 |
Last Update Date | 2021-12-31 |