NPI | 1417921503 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA NN092316) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NJ NN092316) |
Enumeration Date | 2006-02-15 |
Last Update Date | 2017-11-29 |