NPI | 1700382660 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 21698) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC 0205244) |
Enumeration Date | 2018-03-31 |
Last Update Date | 2021-09-09 |