NPI | 1407079817 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 4316) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024164062) |
363LF0000X Nurse Practitioner, Family (Licence: NC 5008466) | |
Enumeration Date | 2007-04-11 |
Last Update Date | 2016-04-27 |