NPI | 1497085674 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV 62857) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA SP010566) |
Enumeration Date | 2010-01-11 |
Last Update Date | 2025-09-15 |