NPI | 1770829277 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5006005) |
Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care (Licence: NC 5006005) |
Enumeration Date | 2013-01-02 |
Last Update Date | 2022-08-02 |