NPI | 1164962288 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AL 1-122021) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN264897) |
Enumeration Date | 2017-03-08 |
Last Update Date | 2018-01-03 |