NPI | 1629289814 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 0050-03026) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA 242675) |
Enumeration Date | 2007-05-27 |
Last Update Date | 2007-12-04 |