NPI | 1194077875 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN137657) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OR 1004077) |
363LF0000X Nurse Practitioner, Family (Licence: AL 1-082574) | |
Enumeration Date | 2012-10-05 |
Last Update Date | 2025-05-07 |