NPI | 1275969081 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WI 10659) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA 218472) |
363LF0000X Nurse Practitioner, Family (Licence: GA RN218472) | |
363LF0000X Nurse Practitioner, Family (Licence: TN 17937) | |
Enumeration Date | 2013-09-25 |
Last Update Date | 2021-11-30 |