NPI | 1538557582 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA SP019228) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2290563) |
Enumeration Date | 2014-12-29 |
Last Update Date | 2018-11-09 |