NPI | 1639553639 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: LA AP08358) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MS 902402) |
363LF0000X Nurse Practitioner, Family (Licence: LA AP08358) | |
Enumeration Date | 2015-07-20 |
Last Update Date | 2018-08-20 |