NPI | 1619256195 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024169041) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0001082644) |
Enumeration Date | 2011-08-15 |
Last Update Date | 2011-08-15 |