NPI | 1417958364 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 3128) |
Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: CT 3128) |
Enumeration Date | 2005-08-02 |
Last Update Date | 2016-02-03 |