NPI | 1376793588 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN163021) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VI 10336P) |
363L00000X Nurse Practitioner (Licence: CT 6713) | |
363LA2200X Nurse Practitioner, Adult Health (Licence: AK 1025) | |
Enumeration Date | 2008-09-24 |
Last Update Date | 2019-11-13 |