NPI | 1487027678 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CT 6422) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CT 2015013345) |
Enumeration Date | 2015-11-10 |
Last Update Date | 2018-07-30 |