NPI | 1053627083 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 9290547) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL 9290547) |
Enumeration Date | 2010-08-27 |
Last Update Date | 2010-08-27 |