NPI | 1235835570 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11024247) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN293183) |
Enumeration Date | 2023-02-07 |
Last Update Date | 2023-02-07 |