NPI | 1508146523 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024169540) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001150149) |
Enumeration Date | 2011-08-22 |
Last Update Date | 2016-07-04 |