NPI | 1194059162 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA 190189) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 17456) |
Enumeration Date | 2009-09-24 |
Last Update Date | 2009-10-09 |