NPI | 1104001866 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NM CNP00224) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NM R17140) |
Enumeration Date | 2007-12-31 |
Last Update Date | 2017-11-30 |