NPI | 1316486012 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024178082) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA SP017210) |
Enumeration Date | 2017-02-15 |
Last Update Date | 2020-12-29 |