NPI | 1689206716 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV 105400) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024178665) |
Enumeration Date | 2020-02-06 |
Last Update Date | 2021-06-30 |