NPI | 1245668318 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN256617) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 840884) |
Enumeration Date | 2013-10-28 |
Last Update Date | 2019-08-20 |