NPI | 1235786674 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024178306) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001225520) |
Enumeration Date | 2019-08-21 |
Last Update Date | 2021-07-30 |