NPI | 1790803278 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS R850198) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: LA RN099890) |
Enumeration Date | 2007-03-26 |
Last Update Date | 2019-09-05 |