NPI | 1710695960 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11022875) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL 11022875) |
Enumeration Date | 2022-11-07 |
Last Update Date | 2024-01-04 |