NPI | 1508381039 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MO 2017029363) |
Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: MO AG07170077) |
Enumeration Date | 2017-08-05 |
Last Update Date | 2018-04-18 |