NPI | 1083040562 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MS 870536) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MS 870536) |
Enumeration Date | 2013-09-17 |
Last Update Date | 2020-09-16 |