NPI | 1972191831 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11010989) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL 9371116) |
363LP2300X Nurse Practitioner, Primary Care (Licence: FL APRN11010989) | |
Enumeration Date | 2021-01-06 |
Last Update Date | 2021-03-26 |