NPI | 1093183873 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 4906080-4405) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: UT 4906080-8900) |
Enumeration Date | 2015-09-09 |
Last Update Date | 2015-12-18 |