NPI | 1568792893 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 9348138) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 14321) |
Enumeration Date | 2010-01-08 |
Last Update Date | 2014-07-16 |