NPI | 1720490386 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: VA 0024173116) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VA 0024173116) |
363LW0102X Nurse Practitioner, Women's Health (Licence: TN APN0000018429) | |
Enumeration Date | 2014-05-29 |
Last Update Date | 2023-08-20 |