NPI | 1093478331 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11015837) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA APRN11015837) |
Enumeration Date | 2021-10-13 |
Last Update Date | 2022-09-20 |