NPI | 1053680728 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024169613) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0024169613) |
Enumeration Date | 2011-12-23 |
Last Update Date | 2023-11-18 |