NPI | 1073094314 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 9361455) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL RN9361455) |
Enumeration Date | 2018-08-24 |
Last Update Date | 2018-10-12 |