NPI | 1417074824 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OH COA14354NP) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN 169061 NP) |
Enumeration Date | 2007-03-23 |
Last Update Date | 2016-06-14 |