NPI | 1104374693 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024177684) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 819106) |
Enumeration Date | 2016-09-14 |
Last Update Date | 2024-02-21 |