NPI | 1396096293 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ AP4666) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3017056) |
Enumeration Date | 2012-10-02 |
Last Update Date | 2024-10-15 |