NPI | 1124751961 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WV 106787) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: MD AC004537) |
Enumeration Date | 2022-07-08 |
Last Update Date | 2024-09-05 |