NPI | 1942465570 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MO 121969) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 5878) |
Enumeration Date | 2008-07-23 |
Last Update Date | 2015-05-28 |