NPI | 1629442694 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024173176) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 20561) |
Enumeration Date | 2015-11-13 |
Last Update Date | 2017-02-06 |