NPI | 1386032399 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5007411) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC F0814271) |
Enumeration Date | 2014-12-26 |
Last Update Date | 2020-05-15 |