NPI | 1255661955 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CO 0000841) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WV 40413) |
Enumeration Date | 2010-01-04 |
Last Update Date | 2023-03-30 |