NPI | 1104360825 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MD R204594) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: DC RN1011865) |
Enumeration Date | 2016-12-14 |
Last Update Date | 2016-12-14 |