NPI | 1184164089 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024174662) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WV APRN73140-NP-C) |
Enumeration Date | 2017-02-27 |
Last Update Date | 2024-02-05 |