NPI | 1366861478 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL arnp9378968) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA 266641) |
Enumeration Date | 2014-04-16 |
Last Update Date | 2015-03-11 |