NPI | 1497206601 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024174114) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NJ 26NJ00867400) |
Enumeration Date | 2016-10-24 |
Last Update Date | 2020-06-29 |