NPI | 1811667124 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: FL 11015451) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL 11015451) |
Enumeration Date | 2021-09-17 |
Last Update Date | 2021-11-23 |