NPI | 1063748788 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: GA RN192280) |
Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: GA RN192280) |
Enumeration Date | 2009-10-30 |
Last Update Date | 2020-09-22 |