NPI | 1194953448 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MD R118578) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: WV APRN86992) |
363LA2200X Nurse Practitioner, Adult Health (Licence: PA SP012028) | |
Enumeration Date | 2009-06-25 |
Last Update Date | 2019-08-26 |