NPI | 1336133917 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: MD R222718) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA SP001583H) |
Enumeration Date | 2005-09-09 |
Last Update Date | 2017-03-13 |