NPI | 1649385444 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD R124009) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MD R124009) |
Enumeration Date | 2006-08-20 |
Last Update Date | 2007-09-12 |