NPI | 1114110558 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NM R39646) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: NM CNP00871) |
Enumeration Date | 2007-08-20 |
Last Update Date | 2023-11-15 |