NPI | 1386778686 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 163W00000X Registered Nurse (Licence: LA RN058863) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: LA AP03695) |
Enumeration Date | 2007-03-16 |
Last Update Date | 2007-07-09 |