NPI | 1174628994 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 44544) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 115979) |
363LF0000X Nurse Practitioner, Family (Licence: MO 115979) | |
Enumeration Date | 2006-09-14 |
Last Update Date | 2015-06-05 |