NPI | 1063690907 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 3521) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN164422) |
Enumeration Date | 2008-02-02 |
Last Update Date | 2024-02-12 |