NPI | 1316227820 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: LA AP06642) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: LA TAP002663) |
Enumeration Date | 2011-08-29 |
Last Update Date | 2018-03-17 |