NPI | 1124449434 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA SP017116) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: PA SP012935) |
Enumeration Date | 2014-01-05 |
Last Update Date | 2017-03-03 |