NPI | 1114407137 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MS 902700) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: LA AP10193) |
Enumeration Date | 2018-08-20 |
Last Update Date | 2019-02-13 |