NPI | 1184087553 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 9302958) |
Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: FL 9302958) |
Enumeration Date | 2016-04-01 |
Last Update Date | 2017-02-14 |