NPI | 1861603128 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AL 1-075812) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA 187301) |
363LP0200X Nurse Practitioner, Pediatrics (Licence: AL 1-075812) | |
Enumeration Date | 2007-05-25 |
Last Update Date | 2021-07-19 |