NPI | 1053761924 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024186726) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: UT 8635924-4405) |
Enumeration Date | 2016-06-21 |
Last Update Date | 2024-09-20 |