NPI | 1336543511 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5007281) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WV APRN8112NP) |
Enumeration Date | 2014-10-16 |
Last Update Date | 2024-10-25 |