NPI | 1114402245 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 22144) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 5012128) |
Enumeration Date | 2018-09-25 |
Last Update Date | 2019-08-20 |