NPI | 1285770305 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WY 20234.0234) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CO 124523) |
Enumeration Date | 2007-01-29 |
Last Update Date | 2007-07-09 |