NPI | 1982065504 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AL 1-136255) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: AL 1-136255) |
Enumeration Date | 2016-03-09 |
Last Update Date | 2016-03-09 |