NPI | 1003167735 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2012034634) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MO 148478) |
363LA2200X Nurse Practitioner, Adult Health (Licence: MO 2012034634) | |
Enumeration Date | 2012-09-20 |
Last Update Date | 2012-10-31 |