NPI | 1811150063 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CO 5569) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CO 173341) |
363LF0000X Nurse Practitioner, Family (Licence: TX 876) | |
Enumeration Date | 2008-07-08 |
Last Update Date | 2018-03-17 |