NPI | 1508133927 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MD R068465) |
Additional Taxonomies | 207QB0002X Family Medicine, Bariatric Medicine (Licence: MD ANCC-0021755) |
Enumeration Date | 2011-11-30 |
Last Update Date | 2011-11-30 |