NPI | 1255819348 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 12.007724) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CT 12.007724) |
Enumeration Date | 2018-08-01 |
Last Update Date | 2018-08-16 |