NPI | 1629328075 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 71004137A) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3007678) |
Enumeration Date | 2012-09-13 |
Last Update Date | 2014-04-01 |