NPI | 1063430635 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CO 20018) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NH 026832-23-03) |
Enumeration Date | 2006-07-18 |
Last Update Date | 2010-10-07 |