NPI | 1134754088 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN298748) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL APRN11003708) |
363LF0000X Nurse Practitioner, Family (Licence: GA APRN298748) | |
Enumeration Date | 2020-03-10 |
Last Update Date | 2022-09-30 |