NPI | 1639441264 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 201250100NP) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: UT 201500-4405) |
Enumeration Date | 2012-01-27 |
Last Update Date | 2018-08-27 |