NPI | 1801580063 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV 117099) |
Additional Taxonomies | 163WD0400X Registered Nurse, Diabetes Educator (Licence: WV 68536) |
Enumeration Date | 2023-06-08 |
Last Update Date | 2024-02-06 |