NPI | 1417586884 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0024179706) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001239026) |
363LA2200X Nurse Practitioner, Adult Health (Licence: VA 0024179706) | |
Enumeration Date | 2020-04-07 |
Last Update Date | 2021-10-26 |