NPI | 1487056354 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2014033138) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 76487) |
Enumeration Date | 2014-09-22 |
Last Update Date | 2016-12-26 |