NPI | 1104492586 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN291913) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN291913) |
Enumeration Date | 2021-05-27 |
Last Update Date | 2024-10-28 |