NPI | 1538794565 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024182464) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 23687) |
Enumeration Date | 2020-03-10 |
Last Update Date | 2023-05-08 |