NPI | 1295185676 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 9484394) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024173648) |
Enumeration Date | 2016-06-16 |
Last Update Date | 2019-05-15 |