NPI | 1073000816 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024175910) |
Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: NC WYNE-WLK81) |
Enumeration Date | 2018-04-17 |
Last Update Date | 2024-09-19 |