NPI | 1235551656 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024172376) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 18625) |
Enumeration Date | 2014-01-21 |
Last Update Date | 2016-04-19 |