NPI | 1003065731 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: LA AP08376) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: LA RN148719) |
Enumeration Date | 2008-09-18 |
Last Update Date | 2017-11-29 |