NPI | 1215167333 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024172253) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 5001114) |
363LF0000X Nurse Practitioner, Family (Licence: NC 0050-01114) | |
Enumeration Date | 2009-07-23 |
Last Update Date | 2018-03-17 |