NPI | 1366582066 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN2633702) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 2633702) |
Enumeration Date | 2007-02-08 |
Last Update Date | 2019-10-25 |