NPI | 1972875557 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 209836) |
Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: NC 5005460) |
Enumeration Date | 2012-01-30 |
Last Update Date | 2018-05-30 |