NPI | 1750829909 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 23534) |
Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: AL 1136630) |
363LF0000X Nurse Practitioner, Family (Licence: AL 1-136630) | |
Enumeration Date | 2017-02-08 |
Last Update Date | 2017-11-15 |