NPI | 1376882340 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AL 1-099725) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA rn178001) |
Enumeration Date | 2013-02-11 |
Last Update Date | 2015-02-24 |