NPI | 1629444088 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024178072) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY F339829) |
Enumeration Date | 2015-08-19 |
Last Update Date | 2024-09-05 |