NPI | 1679095350 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11016885) |
Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: CA 95005912) |
207QA0505X Family Medicine, Adult Medicine (Licence: FL APRN11016885) | |
Enumeration Date | 2017-07-13 |
Last Update Date | 2022-08-15 |