NPI | 1679012629 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AL 1-110409) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL ARNP9337614) |
Enumeration Date | 2017-02-22 |
Last Update Date | 2017-03-03 |