NPI | 1124660659 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN165381) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA RN165381) |
Enumeration Date | 2019-10-16 |
Last Update Date | 2023-05-01 |