NPI | 1124321088 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ AP8039) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CT 004566) |
Enumeration Date | 2010-12-15 |
Last Update Date | 2018-03-17 |