NPI | 1043756745 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024174293) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 001217310) |
Enumeration Date | 2017-01-18 |
Last Update Date | 2022-07-27 |