NPI | 1700922358 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ AP1463) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA 211196 NP) |
Enumeration Date | 2007-01-30 |
Last Update Date | 2018-03-17 |