NPI | 1558814111 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV APRN70960-FNP-BC) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: WV 70960) |
Enumeration Date | 2016-08-01 |
Last Update Date | 2019-02-27 |