NPI | 1376083147 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 8336955-4405) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: UT 8336955-8900) |
Enumeration Date | 2017-02-27 |
Last Update Date | 2017-04-26 |