NPI | 1518984038 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 17779) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC APN17779) |
363LF0000X Nurse Practitioner, Family (Licence: NH 039987-23-03) | |
363LF0000X Nurse Practitioner, Family (Licence: NC 5006386) | |
Enumeration Date | 2006-07-17 |
Last Update Date | 2019-01-26 |