NPI | 1578877320 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: DC 1024435) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CT 4401) |
Enumeration Date | 2010-08-04 |
Last Update Date | 2011-10-04 |