NPI | 1265804041 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 22742) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN201903) |
Enumeration Date | 2015-10-20 |
Last Update Date | 2022-11-03 |