NPI | 1396129821 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV APRN61039) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 5008531) |
Enumeration Date | 2015-07-14 |
Last Update Date | 2024-10-10 |