NPI | 1699301184 |
---|---|
Other Name | NA NA NA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11006626) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL APRN11006626) |
Enumeration Date | 2020-03-17 |
Last Update Date | 2023-11-27 |