NPI | 1417382466 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MD R219551) |
Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: MD R219551) |
363LP2300X Nurse Practitioner, Primary Care (Licence: NC 5006405) | |
Enumeration Date | 2013-09-10 |
Last Update Date | 2020-11-24 |