NPI | 1336194430 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 9464400) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MO RN144693) |
Enumeration Date | 2006-05-24 |
Last Update Date | 2017-10-19 |