NPI | 1962024257 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV 105148) |
Additional Taxonomies | 163WR0006X Registered Nurse, Registered Nurse First Assistant (Licence: WV 105148) |
363L00000X Nurse Practitioner (Licence: KY 3014474) | |
363LF0000X Nurse Practitioner, Family (Licence: KY 3014474) | |
Enumeration Date | 2020-05-11 |
Last Update Date | 2022-08-12 |