NPI | 1356963300 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MD AC003883) |
Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: WV 106828) |
Enumeration Date | 2020-05-13 |
Last Update Date | 2024-07-16 |