NPI | 1598121220 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 19659) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 5008608) |
Enumeration Date | 2016-01-11 |
Last Update Date | 2016-09-02 |