NPI | 1104334846 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN216672) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA F01180323) |
Enumeration Date | 2018-01-16 |
Last Update Date | 2023-03-14 |