NPI | 1578867479 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WI F11170044) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI F1117044) |
390200000X Student in an Organized Health Care Education/Training Program (Licence: WI 175794-30) | |
Enumeration Date | 2011-01-06 |
Last Update Date | 2018-03-17 |