NPI | 1164193702 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024182739) |
Additional Taxonomies | 207QA0401X Family Medicine, Addiction Medicine (Licence: VA 0024182739) |
Enumeration Date | 2021-09-23 |
Last Update Date | 2024-05-14 |