NPI | 1063910057 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN209302) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA RN209302) |
363LF0000X Nurse Practitioner, Family (Licence: FL APRN11028001) | |
Enumeration Date | 2018-01-25 |
Last Update Date | 2024-02-06 |