NPI | 1609050285 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024164203) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001135090) |
Enumeration Date | 2007-12-19 |
Last Update Date | 2018-07-13 |