NPI | 1336677491 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2017020147) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 77716) |
Enumeration Date | 2017-06-01 |
Last Update Date | 2017-07-24 |