NPI | 1043637598 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN201648) |
Additional Taxonomies | 282NR1301X General Acute Care Hospital, Rural (Licence: GA RN201648) |
Enumeration Date | 2014-03-22 |
Last Update Date | 2014-04-25 |