NPI | 1063852036 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ AP5118) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2293471) |
Enumeration Date | 2013-07-05 |
Last Update Date | 2014-09-19 |