NPI | 1396733580 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024172441) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 3187042) |
Enumeration Date | 2005-10-11 |
Last Update Date | 2019-02-05 |