NPI | 1104307354 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IA A117107) |
Additional Taxonomies | 363LW0102X Nurse Practitioner, Women's Health (Licence: IA F117107) |
Enumeration Date | 2018-08-26 |
Last Update Date | 2018-08-26 |