NPI | 1043363534 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5004102) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA SP008019) |
Enumeration Date | 2007-01-19 |
Last Update Date | 2015-07-21 |