NPI | 1497758551 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 5587) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024166194) |
Enumeration Date | 2005-05-23 |
Last Update Date | 2018-06-05 |