NPI | 1083890461 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO MO2001019721) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 45766) |
Enumeration Date | 2008-01-15 |
Last Update Date | 2020-08-24 |