NPI | 1104975747 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5006705) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OH NP-07477) |
363L00000X Nurse Practitioner (Licence: NC 5006705) | |
Enumeration Date | 2007-01-10 |
Last Update Date | 2016-12-08 |