NPI | 1205056637 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MT 21240) |
Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: MT 363LF0000X) |
Enumeration Date | 2007-04-26 |
Last Update Date | 2012-01-31 |