NPI | 1174873731 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL ARNP9398726) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AL 1-097478) |
Enumeration Date | 2012-09-11 |
Last Update Date | 2015-08-27 |