NPI | 1194408773 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024187712) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WV 117436) |
Enumeration Date | 2023-08-09 |
Last Update Date | 2025-06-17 |