NPI | 1306202064 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 9456068) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA RN240228) |
Enumeration Date | 2016-01-12 |
Last Update Date | 2021-08-18 |