NPI | 1487019394 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2015016090) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MO 2015016090) |
Enumeration Date | 2015-12-18 |
Last Update Date | 2018-01-24 |