NPI | 1508308065 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WY 385656.1564) |
Additional Taxonomies | 363LW0102X Nurse Practitioner, Women's Health (Licence: WY 38656.1564) |
Enumeration Date | 2016-11-14 |
Last Update Date | 2018-03-17 |