NPI | 1386824522 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD rn107090) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: DC rn55311) |
Enumeration Date | 2007-11-05 |
Last Update Date | 2007-11-05 |