NPI | 1346623956 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: KY 4002839) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: MO 2008023126) |
363LA2200X Nurse Practitioner, Adult Health (Licence: WV 116231) | |
Enumeration Date | 2015-06-30 |
Last Update Date | 2023-06-27 |