NPI | 1831474394 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 12.005362) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 643800-1) |
Enumeration Date | 2011-10-17 |
Last Update Date | 2018-12-05 |