NPI | 1124436290 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: LA AP07877) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: LA RN123121) |
Enumeration Date | 2014-08-01 |
Last Update Date | 2014-08-01 |