NPI | 1083094759 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: WI 8436) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: CO APN.0991790-NP) |
Enumeration Date | 2015-06-08 |
Last Update Date | 2018-06-15 |