NPI | 1588670525 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MO 110739) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2014007469) |
Enumeration Date | 2006-07-31 |
Last Update Date | 2020-04-03 |