NPI | 1730714197 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL APRN11003777) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11003777) |
Enumeration Date | 2020-03-06 |
Last Update Date | 2020-09-30 |