NPI | 1164061032 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 23112) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN289999) |
Enumeration Date | 2019-12-24 |
Last Update Date | 2022-11-08 |