NPI | 1790293215 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024191377) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 5010222) |
163W00000X Registered Nurse (Licence: NC 261868) | |
Enumeration Date | 2018-01-18 |
Last Update Date | 2025-09-12 |