NPI | 1760675177 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NE 110931) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IA A-061552) |
Enumeration Date | 2007-08-20 |
Last Update Date | 2012-08-14 |