NPI | 1235480880 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS 810649) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: MS R872871) |
363LF0000X Nurse Practitioner, Family (Licence: UT 8434518-4405) | |
363LF0000X Nurse Practitioner, Family (Licence: FL 9416834) | |
Enumeration Date | 2012-09-23 |
Last Update Date | 2017-01-24 |