NPI | 1790444875 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NM 73714) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: NM 73714) |
363LF0000X Nurse Practitioner, Family (Licence: FL 11017032) | |
Enumeration Date | 2021-12-15 |
Last Update Date | 2023-10-10 |