NPI | 1720475767 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024179409) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: ND R41949) |
Enumeration Date | 2015-04-16 |
Last Update Date | 2024-01-12 |