NPI | 1376869677 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA SP010721) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 19076) |
Enumeration Date | 2010-04-12 |
Last Update Date | 2022-03-15 |