NPI | 1730389743 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: TN 15960) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AR A01012 ANP) |
Enumeration Date | 2007-07-19 |
Last Update Date | 2019-03-04 |