NPI | 1861069866 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11013564) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 11013564) |
363LA2200X Nurse Practitioner, Adult Health (Licence: FL 11013564) | |
363LP2300X Nurse Practitioner, Primary Care (Licence: FL 11013564) | |
Enumeration Date | 2021-06-08 |
Last Update Date | 2021-06-08 |