NPI | 1053937060 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD R222016) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WV 108391) |
363LF0000X Nurse Practitioner, Family (Licence: PA SP023540) | |
Enumeration Date | 2020-06-25 |
Last Update Date | 2022-10-20 |