NPI | 1164664348 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MS R701653) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MS R701653) |
Enumeration Date | 2009-04-02 |
Last Update Date | 2020-08-18 |