NPI | 1184960338 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11023342) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WV APRN53997) |
Enumeration Date | 2012-12-17 |
Last Update Date | 2023-06-08 |