NPI | 1760947287 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11000265) |
Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: FL 11000265) |
Enumeration Date | 2019-02-08 |
Last Update Date | 2021-12-01 |