NPI | 1053733857 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN291455) |
Additional Taxonomies | 163WM0705X Registered Nurse, Medical-Surgical (Licence: NY 477562-1) |
363LF0000X Nurse Practitioner, Family (Licence: FL ARNP9197326) | |
Enumeration Date | 2014-01-13 |
Last Update Date | 2022-03-24 |