NPI | 1235415217 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV 63888) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WV APRN63888) |
Enumeration Date | 2011-10-22 |
Last Update Date | 2021-05-24 |