NPI | 1730487885 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA SP011897) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: PA SP010440) |
Enumeration Date | 2011-03-13 |
Last Update Date | 2012-08-14 |