NPI | 1104123983 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD R192113) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: MD R192113) |
Enumeration Date | 2011-02-14 |
Last Update Date | 2020-03-02 |