NPI | 1114441458 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 21222) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: SC 219744) |
Enumeration Date | 2017-07-28 |
Last Update Date | 2017-10-12 |