NPI | 1104918200 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN135621) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA 135621) |
Enumeration Date | 2006-09-28 |
Last Update Date | 2023-05-31 |