NPI | 1528242088 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WY 15060.0935) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CO 181545) |
Enumeration Date | 2007-12-19 |
Last Update Date | 2010-07-06 |