NPI | 1518100031 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 22363) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2267768) |
363LF0000X Nurse Practitioner, Family (Licence: FL 9227228) | |
Enumeration Date | 2009-04-14 |
Last Update Date | 2015-12-15 |