NPI | 1124486436 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IA A114412) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: IA A114412) |
Enumeration Date | 2016-02-01 |
Last Update Date | 2016-02-01 |