NPI | 1104360122 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ AP9704) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AZ NP9704) |
Enumeration Date | 2016-12-09 |
Last Update Date | 2019-06-21 |