NPI | 1003216813 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: LA AP07786) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: LA AP07786) |
Enumeration Date | 2014-08-28 |
Last Update Date | 2018-06-05 |