NPI | 1356528533 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WV 24311) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WV APRN24311-FNP-BC) |
Enumeration Date | 2008-01-30 |
Last Update Date | 2015-11-12 |