NPI | 1356972954 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024178753) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 27017) |
Enumeration Date | 2020-02-01 |
Last Update Date | 2020-07-16 |