NPI | 1720322936 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 9307372) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY F332248-1) |
Enumeration Date | 2012-11-12 |
Last Update Date | 2012-11-12 |