NPI | 1366616344 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MS A810661) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 13403) |
Enumeration Date | 2008-04-21 |
Last Update Date | 2019-10-25 |