NPI | 1568720381 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: NC 5010517) |
Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: WV 62109) |
Enumeration Date | 2012-04-30 |
Last Update Date | 2018-05-23 |