NPI | 1114483906 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL 11007563) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN270524) |
Enumeration Date | 2019-02-16 |
Last Update Date | 2024-09-10 |