NPI | 1528045440 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: NE 110742) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NE 110742) |
Enumeration Date | 2005-12-30 |
Last Update Date | 2021-10-06 |