NPI | 1861508855 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA SP002270B) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WV 37115) |
Enumeration Date | 2006-08-22 |
Last Update Date | 2007-07-08 |