NPI | 1245866151 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 23628) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN244670) |
Enumeration Date | 2020-03-23 |
Last Update Date | 2023-06-30 |