NPI | 1932778107 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 25444) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC 25444) |
207QA0505X Family Medicine, Adult Medicine (Licence: SC 542224) | |
Enumeration Date | 2021-06-22 |
Last Update Date | 2025-02-26 |