NPI | 1518190404 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD R177602) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA SP010424) |
Enumeration Date | 2009-08-26 |
Last Update Date | 2014-12-08 |