NPI | 1245586494 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AK No. 1150) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 345328) |
Enumeration Date | 2012-07-25 |
Last Update Date | 2020-04-29 |