NPI | 1104331396 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024175686) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024175685) |
Enumeration Date | 2017-12-10 |
Last Update Date | 2020-03-17 |