NPI | 1023550696 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: GA RN202316) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: GA RN202316) |
363LG0600X Nurse Practitioner, Gerontology (Licence: GA RN202316) | |
Enumeration Date | 2016-11-13 |
Last Update Date | 2024-01-10 |