NPI | 1922460856 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WI 10666-33) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WV APRN 48489 FNP-BC) |
363LF0000X Nurse Practitioner, Family (Licence: OH 369874) | |
Enumeration Date | 2016-03-21 |
Last Update Date | 2022-02-22 |