NPI | 1275818270 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024175242) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704261053) |
Enumeration Date | 2011-10-21 |
Last Update Date | 2024-10-04 |