NPI | 1811125099 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: CA 600722) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA 18205) |
Enumeration Date | 2009-06-26 |
Last Update Date | 2025-09-17 |