NPI | 1194096636 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV APRN50731-FNP-BC) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: WV 50731) |
Enumeration Date | 2012-01-13 |
Last Update Date | 2013-07-15 |