NPI | 1932754314 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11003379) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL APRN11003379) |
2083X0100X Preventive Medicine, Occupational Medicine (Licence: FL APRN11003379) | |
Enumeration Date | 2019-08-02 |
Last Update Date | 2021-08-25 |