NPI | 1720379647 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2012000340) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 20164) |
Enumeration Date | 2011-04-26 |
Last Update Date | 2013-03-20 |