NPI | 1760871487 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2014042978) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-76504-011) |
Enumeration Date | 2015-01-19 |
Last Update Date | 2015-01-19 |