NPI | 1750639605 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024173512) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AL 1-072891) |
Enumeration Date | 2012-08-27 |
Last Update Date | 2021-10-12 |