NPI | 1962273342 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11030236) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL 11030236) |
261QP2300X Clinic/Center, Primary Care | |
363L00000X Nurse Practitioner (Licence: FL 11030236) | |
Enumeration Date | 2024-01-12 |
Last Update Date | 2024-06-04 |