NPI | 1518602408 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD ac004484) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WV 117380) |
Enumeration Date | 2022-05-04 |
Last Update Date | 2024-05-30 |