NPI | 1679570550 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024000065) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0001095096) |
Enumeration Date | 2005-07-07 |
Last Update Date | 2009-03-23 |