NPI | 1629320874 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WA AP60309079) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: ME CNP121087) |
Enumeration Date | 2012-10-12 |
Last Update Date | 2015-06-22 |