NPI | 1629332192 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: LA AP06929) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: LA RN137659) |
Enumeration Date | 2012-06-29 |
Last Update Date | 2015-04-08 |