NPI | 1164823753 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV APRN71222FNPBC) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WV 71222) |
Enumeration Date | 2014-09-15 |
Last Update Date | 2022-04-08 |