NPI | 1093799132 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WY 8665.0048) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AK 340) |
Enumeration Date | 2005-12-02 |
Last Update Date | 2017-03-23 |