NPI | 1215281076 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 17065) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN225095) |
Enumeration Date | 2012-11-01 |
Last Update Date | 2016-05-11 |