NPI | 1154719540 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN135482) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA 135482) |
Enumeration Date | 2015-01-07 |
Last Update Date | 2018-03-17 |