NPI | 1629528872 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CT 6643) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CT 2016010756) |
Enumeration Date | 2016-10-12 |
Last Update Date | 2017-01-30 |