NPI | 1235138793 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD R107890) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MD R107890) |
Enumeration Date | 2005-07-18 |
Last Update Date | 2016-08-17 |