NPI | 1265767792 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CO NP 10151) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CO 192552) |
Enumeration Date | 2009-10-16 |
Last Update Date | 2009-10-16 |