NPI | 1811170517 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024166946) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 13647) |
Enumeration Date | 2007-12-17 |
Last Update Date | 2009-02-14 |