NPI | 1407833239 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NM CNP01397) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AZ AP 2038) |
363LF0000X Nurse Practitioner, Family (Licence: CA NP6044) | |
Enumeration Date | 2005-12-22 |
Last Update Date | 2017-03-07 |