NPI | 1801350848 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11001076) |
Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: FL 11001076) |
Enumeration Date | 2019-01-23 |
Last Update Date | 2020-07-21 |