NPI | 1083988489 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ AP11239) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN F0212354) |
Enumeration Date | 2012-03-02 |
Last Update Date | 2021-12-01 |