NPI | 1376263483 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: WV 113429) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WV 113429) |
Enumeration Date | 2022-08-30 |
Last Update Date | 2024-10-11 |