NPI | 1205374139 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: PA SP017074) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: DE LP-0000190) |
Enumeration Date | 2017-02-12 |
Last Update Date | 2018-09-21 |