NPI | 1811992274 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 9372494) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH 07808NP) |
Enumeration Date | 2005-06-14 |
Last Update Date | 2014-01-28 |