NPI | 1922395300 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA SP013175) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: PA SP011464) |
Enumeration Date | 2011-07-06 |
Last Update Date | 2018-12-09 |