NPI | 1144651894 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11015625) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 842651) |
363LF0000X Nurse Practitioner, Family (Licence: GA RN252726) | |
Enumeration Date | 2013-12-05 |
Last Update Date | 2023-04-14 |