NPI | 1134627169 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024177677) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN220132) |
363LF0000X Nurse Practitioner, Family (Licence: FL ARNP9409299) | |
Enumeration Date | 2018-01-24 |
Last Update Date | 2023-01-10 |