NPI | 1053865782 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: FL ARNP9453375) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704271366) |
363LF0000X Nurse Practitioner Family (Licence: MI 4704271366) | |
Enumeration Date | 2016-08-10 |
Last Update Date | 2018-01-12 |