NPI | 1154386704 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11025745) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WV 35689) |
363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: WV 35689) | |
Enumeration Date | 2006-04-18 |
Last Update Date | 2024-06-05 |