NPI | 1700275260 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV APRN86632-FNP-BC) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3009186) |
Enumeration Date | 2015-01-21 |
Last Update Date | 2021-11-18 |