NPI | 1003683095 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA NP002505) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 353196) |
Enumeration Date | 2023-12-08 |
Last Update Date | 2025-03-26 |