NPI | 1750712568 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024178240) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 23774) |
Enumeration Date | 2013-12-03 |
Last Update Date | 2020-06-23 |