NPI | 1700272853 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD R120346) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MD CRNP120346) |
Enumeration Date | 2015-04-15 |
Last Update Date | 2018-06-14 |