NPI | 1780941831 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024171615) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WV 51009) |
Enumeration Date | 2012-04-13 |
Last Update Date | 2022-08-01 |