NPI | 1003364795 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD R219914) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MD R219914) |
363LF0000X Nurse Practitioner, Family (Licence: DC RN1025415) | |
Enumeration Date | 2016-09-12 |
Last Update Date | 2019-06-06 |