NPI | 1093901274 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD R213017) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA RN280341) |
363LF0000X Nurse Practitioner, Family (Licence: WV 79411) | |
363LF0000X Nurse Practitioner, Family (Licence: VA 0024169074) | |
Enumeration Date | 2007-09-20 |
Last Update Date | 2023-05-31 |