NPI | 1508425463 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024177318) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MD AC002784) |
363LF0000X Nurse Practitioner, Family (Licence: FL APRN11020731) | |
Enumeration Date | 2019-06-13 |
Last Update Date | 2023-05-22 |