NPI | 1912097080 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024167555) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 2141172) |
363LF0000X Nurse Practitioner, Family (Licence: CA 444094) | |
363LF0000X Nurse Practitioner, Family (Licence: NY FF334994-01) | |
Enumeration Date | 2006-10-12 |
Last Update Date | 2024-03-13 |