NPI | 1871067447 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 8105) |
Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: CT 000000000) |
Enumeration Date | 2019-01-17 |
Last Update Date | 2022-12-14 |