NPI | 1033588520 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2015025653) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 76853) |
Enumeration Date | 2015-09-15 |
Last Update Date | 2015-09-15 |