NPI | 1689007643 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV APRN84842NP) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MD R207242) |
Enumeration Date | 2013-08-14 |
Last Update Date | 2022-04-07 |