NPI | 1023528460 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA 115789) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC RN107817R) |
Enumeration Date | 2017-10-11 |
Last Update Date | 2018-09-06 |