NPI | 1619330610 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024173386) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001217269) |
Enumeration Date | 2016-03-29 |
Last Update Date | 2021-08-02 |