NPI | 1336505049 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV APRN90027-FNP-BC) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3010278) |
363LF0000X Nurse Practitioner, Family (Licence: NV 810074) | |
Enumeration Date | 2016-01-11 |
Last Update Date | 2023-01-18 |