NPI | 1235535584 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 005989) |
Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: CT 5989) |
Enumeration Date | 2014-11-14 |
Last Update Date | 2017-03-27 |