NPI | 1619926730 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MO 055167) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 055167) |
Enumeration Date | 2006-05-08 |
Last Update Date | 2007-07-08 |