NPI | 1811178221 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV 71585) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: OH 337444) |
363LF0000X Nurse Practitioner, Family (Licence: KY 3008665) | |
Enumeration Date | 2007-11-14 |
Last Update Date | 2021-03-26 |