NPI | 1235626003 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN221014) |
Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: GA RN221014) |
Enumeration Date | 2018-04-17 |
Last Update Date | 2019-02-11 |