NPI | 1154500189 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NH 070479-23) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA 252353) |
Enumeration Date | 2007-10-26 |
Last Update Date | 2014-10-20 |