NPI | 1891047155 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2013045361) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 75769) |
Enumeration Date | 2012-10-11 |
Last Update Date | 2018-01-17 |