NPI | 1194208751 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN197952) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA F08180511) |
Enumeration Date | 2018-09-10 |
Last Update Date | 2019-04-29 |