NPI | 1558746693 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 9356359) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN 9356359) |
Enumeration Date | 2015-07-29 |
Last Update Date | 2018-10-10 |