NPI | 1861019366 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024170597) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL APRN11007816) |
Enumeration Date | 2020-06-30 |
Last Update Date | 2025-01-31 |