NPI | 1700221504 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WA AP60408845) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN RN0000184343) |
Enumeration Date | 2013-05-07 |
Last Update Date | 2014-01-17 |