NPI | 1174665319 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 163W00000X Registered Nurse (Licence: AZ RN116847) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AZ AP1571) |
Enumeration Date | 2007-02-13 |
Last Update Date | 2007-07-08 |