NPI | 1407259641 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA SP015924) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MD R193882) |
Enumeration Date | 2014-10-02 |
Last Update Date | 2022-11-01 |