NPI | 1578846895 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ AP4208) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN CNP2389) |
Enumeration Date | 2011-09-22 |
Last Update Date | 2019-09-12 |