NPI | 1376136887 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024183370) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 347121) |
Enumeration Date | 2021-02-16 |
Last Update Date | 2022-05-29 |