NPI | 1104120864 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WI 4344-33) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WI 70606) |
Enumeration Date | 2011-01-10 |
Last Update Date | 2015-04-07 |