NPI | 1366790644 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD R154872) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: DC 1024731) |
Enumeration Date | 2012-08-17 |
Last Update Date | 2013-12-03 |