NPI | 1740568443 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AL 1-090748) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MS R870697) |
Enumeration Date | 2011-07-28 |
Last Update Date | 2020-05-18 |