NPI | 1376884759 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NM CNP-03012) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 17304) |
Enumeration Date | 2013-03-08 |
Last Update Date | 2017-01-06 |