NPI | 1407286479 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL 9370324) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 9370324) |
Enumeration Date | 2013-11-12 |
Last Update Date | 2014-05-20 |