NPI | 1780129775 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AL 1-143492) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: LA RN145892) |
363LF0000X Nurse Practitioner, Family (Licence: LA AP09088) | |
Enumeration Date | 2016-12-29 |
Last Update Date | 2018-07-18 |