NPI | 1629338884 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 264114) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5006829) |
363L00000X Nurse Practitioner (Licence: CT 4992) | |
Enumeration Date | 2012-05-22 |
Last Update Date | 2018-03-17 |