NPI | 1073670709 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN101397) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CO 178191) |
Enumeration Date | 2007-01-02 |
Last Update Date | 2010-09-10 |