NPI | 1659771616 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: LA AP08686) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: LA RN116548) |
Enumeration Date | 2014-08-27 |
Last Update Date | 2016-03-03 |